RCM Quality Assurance Lead
RCM Quality Assurance Lead
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Job Description
We are united in our mission to make a positive impact on healthcare. Join Us!
- South Florida Business Journal Best Places to Work 2024
- Inc. 5000 FastestGrowing Private Companies in America 2024
- 2024 Black Book Awards ranked #1 EHR in 11 Specialties
- 2024 Spring Digital Health Awards Webbased Digital Health category for EMA Health Records (Gold)
- 2024 Stevie American Business Award (Silver) New Product and Service: Health Technology Solution (Klara)
Who we are:
We Are Modernizing Medicine WAMM! Were a team of bright passionate and positive problemsolvers on a mission to place doctors and patients at the center of care through an intelligent specialtyspecific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling we have grown to over 3400 combined direct and contingent team members serving eleven specialties and we are just getting started! ModMed is based in Boca Raton FL with office locations in Santiago Chile Berlin Germany Hyderabad India and a robust remote workforce with team members across the US.
Your Role:
The Quality Assurance lead role will work closely with Global Partners and the COE Team to monitor and address qualityrelated gaps. They will also ensure that deliverables from the respective teams meet the required quality standards.
Responsibilities:
- Communicate with Global Teams and provide Audit Outcomes for the work audited by the auditors within their Team and by MMI Auditors. Proactive communication across the Teams along with data points is a key responsibility. They will use Jira Quality Dashboards and focused presentations for the same.
- Global Teams provide Audit rebuttals. Quality Supervisors review those and respond with a decision to Global Teams. They will calibrate with the Delivery Teams in order to reduce the rebuttals to the minimum possible to avoid rework.
- Work on all Jira Tickets tagged to them for the quality concerns by Modmed Teams for their book of business( assigned Partners/specialties). They will work and resolve those within TAT
- Audit the Claims where Global Partners tagged those as uncollectible and provide feedback/ approval to write off as per the Modmed guidelines.
- Pick up projects to audit the auditors and have a focused quality review to ensure that DPU frontend quality is > 98 and backend quality is > 95
- Supervise the Quality Auditors and provide regular updates. They have to ensure that Quality Auditors are meeting the daily productivity targets. They will keep a very close eye on the issues reported by the Clients and internal Teams and will ensure that the gaps are identified and permanently fixed within defined timelines both proactively and reactively.
- Ensure that all the Quality improvement levers are being worked on and delivered in a timely manner as per the Quality Strategy. The issues identified and reported are being fixed through a focused plan within defined timelines.
- Keep abreast of all the Process documentation and instructions to make sure that the audits are in line with the processes laid down. They will have a strong understanding on the quality expectations for all the roles under their preview.
Skills & Requirements:
Require 8 years of experience in RCM Domain in AR and above with at least 23 years as Quality supervisor leading a team of 5 auditors in provider RCM . A handson Leader who is a SME in Quality Processes.
- Strong knowledge of Quality Processes
- Proven Track record of creating and implementing CAPA plans
- Highly skilled in DISCOVERY of issues related with Quality
- Strong Communication Writing as well as oral
- Expert in Advanced Excel and PPTs
Preferred Certification in Quality Processes such as Six Sigma TQM etc.
ModMed in India Benefit Highlights:
- High growth collaborative transparent fun and awardwinning culture
- Comprehensive benefits package including medical for you your family and your dependent parents.
- The company supported community engagement opportunities along with a paid Voluntary Time Off day to use for volunteering in your community of interest
- Global presence and inperson collaboration opportunities; dogfriendly HQ (US) Hybrid office based roles and remote availability
- Companysponsored Employee Resource Groups that provide engaged and supportive communities within ModMed
ModMed Benefits Highlight: At ModMed we believe its important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits:
India
- Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk
- Insurance Coverage: Comprehensive health accidental and life insurance plans including coverage for family members all at no cost to employees
- Allowances: Annual wellness allowance to support your wellbeing and productivity
- Earned casual and sick leaves to maintain a healthy worklife balance
- Bereavement leave for difficult times and extended medical leave options
- Paid parental leaves including maternity paternity adoption surrogacy and abortion leave
- Celebration leave to make your special day even more memorable and companypaid holidays to recharge and unwind.
United States
- Comprehensive medical dental and vision benefits including a company Health Savings Account contribution
- 401(k): ModMed provides a matching contribution each payday of 50 of your contribution deferred on up to 6 of your compensation. After one year of employment with ModMed 100 of any matching contribution you receive is yours to keep.
- Generous Paid Time Off and Paid Parental Leave programs
- Company paid Life and Disability benefits Flexible Spending Account and Employee Assistance Programs
- Companysponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
- Professional development opportunities including tuition reimbursement programs and unlimited access to LinkedIn Learning
- Global presence and inperson collaboration opportunities; dogfriendly HQ (US) Hybrid officebased roles and remote availability for some roles
- Weekly catered breakfast and lunch treadmill workstations Zen and wellness rooms within our BRIC headquarters.
PHISHING SCAM WARNING:ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email text and social media. The imposters are creating misleading email accounts conducting remote interviews and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process and valid communications from our hiring team will come from our employees with a ModMed email address . Please check senders email addresses carefully. Additionally ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above please report them to the FTC website.
Employment Type
Full Time
